Organization
PROFESSIONAL GROUP LIVING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NATALKA LOCK MASSEY (EXECUTIVE DIRECTOR)
(919) 475-5845
Entity
Organization
Contact information
Practice address
715 B SOUTHWEST BLVD., CLINTON, NC 28328-4636
(910) 592-2338
Mailing address
715 B SOUTH WEST BLVD., CLINTON, NC 28328-4636
(910) 592-2338
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
02/15/2008
Last updated
12/22/2008
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